Anti-Infective Treatment and Resistance Is Rarely Problematic with Eye Infections

Regis P Kowalski; Shannon V Nayyar; Eric G Romanowski; Vishal Jhanji

doi:10.3390/antibiotics11020204

Anti-Infective Treatment and Resistance Is Rarely Problematic with Eye Infections

Antibiotics (Basel). 2022 Feb 6;11(2):204. doi: 10.3390/antibiotics11020204.

Authors

Regis P Kowalski^{1

2}, Shannon V Nayyar², Eric G Romanowski^{1

2}, Vishal Jhanji^{1

2}

Affiliations

¹ Department of Ophthalmology, The Eye and Ear Institute, School of Medicine, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA 15213, USA.
² The Charles T. Campbell Eye Microbiology Laboratory, Department of Ophthalmology, University of Pittsburgh Medical Center, The Eye and Ear Institute, University of Pittsburgh School of Medicine, 203 Lothrop Street, Room 642, Pittsburgh, PA 15213, USA.

Abstract

The treatment of eye infections is very different than treating other body infections that require systemic anti-infectives. Endophthalmitis, keratitis, conjunctivitis, and other ocular infections are treated with direct injection and with topical drops directly to the infection site. There are no anti-infective susceptibility standards to interpret treatment success, but the systemic standards can be used to guide ocular therapy if the concentration of anti-infective in the ocular tissue is assumed to be higher than the concentration in the blood serum. This Perspective describes: (1) eye infections, (2) diagnostics of eye infections, (3) anti-infective treatment of eye infections, (4) anti-infective resistance of ocular pathogens, and (5) alternative anti-infective delivery and therapy. The data, based on years of clinical and laboratory research, support the premise that ocular infections are less problematic if etiologic agents are laboratory-diagnosed and if prompt, potent, anti-infective therapy is applied. Anti-infective susceptibility should be monitored to assure continued therapeutic success and the possibility of new-found resistance. New delivery systems and therapies may be helpful to better treat future ocular infections.

Keywords: anti-infective susceptibilities; blepharitis; conjunctivitis; endophthalmitis; eye infections; keratitis; ophthalmic anti-infectives; ophthalmic diagnostic testing.